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Private clinics fail inspections, but names kept secret

Nine private medical clinics in Ontario have been found to be providing substandard care that places patients at risk, according to a report to be released Monday by the College of Physicians and Surgeons of Ontario.

Krista Stryland, 32, died after undergoing lipsuction at a cosmetic clinic in 2007. Queen’s Park gave regulatory oversight of private clinics to the College of Physicians and Surgeons of Ontario after Stryland's death.

By:Theresa BoyleHealth Reporter, Published on Mon Dec 03 2012

Nine private medical clinics in Ontario have been found to be providing substandard care that places patients at risk, according to a report to be released Monday by the College of Physicians and Surgeons of Ontario.

But the same legislation that gave the college the authority to inspect the clinics also forbids it from publicly identifying the ones that got failing grades.

The report doesn’t say whether the substandard clinics are still open, identify the doctors who work in them, or reveal if any of those doctors face disciplinary action.

It also does not specify what kinds of services the failing clinics provide.

“We are not allowed to discuss the failed premises,” said Dr. Bob Byrick, president of the college and chair of its “out-of-hospital premises” inspection committee.

Byrick said legislation passed by the province two years ago that gives the college authority to inspect private clinics also prevents it from revealing too much information about them.

Queen’s Park gave regulatory oversight of private clinics to the college following the 2007 death of Krista Stryland, who underwent liposuction surgery at the Toronto Cosmetic Clinic.

The college’s powers are limited to ordering doctors to stop working at the clinics in question and to stop performing procedures for which they failed to meet standards.

The college is releasing its first inspection report Monday. An advanced copy obtained by the Star reveals that of 251 clinics, 178 passed inspection, 64 passed with conditions and nine failed.

In addition to cosmetic surgery, the clinics in question provide colonoscopies, cataract surgery and pain alleviation treatment. They all use anesthesia.

Byrick said he is prohibited by the legislation from revealing how many of the failing clinics provide each of the services in question. Nor, he said, can he reveal where in Ontario they are located.

He was unaware of whether any doctors at failed clinics were facing disciplinary action by the college. And he said he did not know if any of the clinics in question had closed.

NDP health critic France Gelinas maintains that the legislation doesn’t actually preclude the college from naming names, it just does not explicitly state that it can.

She pointed the finger at Ontario’s Liberal government rather than the college, arguing that the province was “sheepish” when it had the opportunity to create stronger legislation.

“This is a remnant of (a time when some thought) doctors knew best and didn’t question the doctor. It brings about in many parts of the health-care system a lack of transparency and lack of accountability,” Gelinas charged.

“It does not serve us well. It might have been fine in 1950s, but we are now in 2012,” she added.

Gelinas said the college is doing the best it can, given that it goes up against doctors with deep pockets.

“They have resources to hire teams of lawyers and it would cost an arm and a leg for that little agency to mount a case against them,” she said.

Byrick said the inspection program should give Ontarians greater confidence in private clinics, especially at a time when they are increasing in number.

“We have to minimize the risk of anesthesia and surgery really in any environment and there are particular risks in out-of-hospital premises that were a gap in regulatory oversight and that has been rectified,” he said.

“So the public should be reassured when they have a procedure done in these premises that in fact the standards meet our expectations,” he added.

The Liberal government wants to move more services out of hospitals and into non-profit clinics. Most of the 251 clinics now operating in Ontario are for-profit. And while they are operated privately, many receive public funds.

It was the result of such an inspection by the college that last year resulted in some 6,800 patients being informed they had a small risk of contracting hepatitis B, C and HIV and being advised to get tested. College assessors discovered that an Ottawa endoscopy clinic had not been properly sanitizing equipment.

While Byrick said he couldn’t discuss specific situations, one case in Ottawa has been widely covered in the media. It was reported that the college ordered the gastroenterologist Dr. Christiane Farazli to stop performing endoscopies. The clinic subsequently closed and the college is investigating Farazli. She is working elsewhere but not performing endoscopies.

When assessing clinics, the college looks at whether there are problems with infection control, qualifications of staff and the types of drugs and equipment being used.

In cases where clinics passed inspections with conditions, they may have been required, for example, to upgrade equipment or mediation.

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